test 2 Flashcards
Barriers to adequate nutrition
impairment in swallowing altered sensory perception poverty or lack of access developmental age medications alcoholism intestinal surface area mechanical fixation
Kcal per gram of fat
9kcal per g
Kcal per gram of carbohydrate
4kcal per g
Kcal per gram of protein
4kcal per g
corticosteroids
take with food or milk to decrease GI upset
oral narcotics
take with food to decrease GI upset
if no food during medications time frame
take 1 hour before or 2 hours after eating
ciprofloxacin
no dairy
tetracycline
no food or dairy
MAOIs
avoid food with tyramine
grapefruit
watch grapefruit juice with many different drugs
nutrients are required for
energy
growth
maintenance
repair
who should be monitored during meal at an extended care facility?
client with Alzheimer’s
mental deficit or aspiration risk
what would you recommend to a client that goes home with nutrition needs?
consult social services for home meal delivery
encourage buying frozen fruit/ veg
recommend drinking supplements
investigate adult community lunch programs
food allergy
overreaction of the immune system of food protein or large molecule body produces antibodies to protect itself
this can be a response that is immediate or delayed up to a day.
most common food allergies
peanuts milk eggs wheat seafood or cross reactive such as ragweed also to melons and bananas.
symptoms of an allergic food reaction
skin- urticaria
GI- nausea, vomiting
respiratory problems difficulty breathing
risk of anaphylaxis
types of diets
NPO clear liquid full liquid pureed diet soft low fiber diet mechanical soft diet regular diet
NPO
nothing by mouth including water
long time needs iv
clear liquid
foods that are clear and liquid at room temp
minimal digestion
(Water, tea, coffee, fat-free broth, carbonated beverages, clear juices, gelatin, popsicles)
reduces gas and fecal material
post op recovery
full liquid diet
any liquids at room temp
if longer than 2-3 days supplement shake needed
intolerance to solid fd or post op recovery
pureed diet
blended diet
food is easier to swallow
some or no foods excluded add broth or water when blending.
soft bland low fiber diet
whole foods low in fiber, lightly seasoned
gas forming foods excluded (fruits, veggies, coarse breads, cereals) beans
GI disorders chewing issues acute infections
in-between full liquids and regular diets
Lactose free diet
food intolerance not allergy
gas bloating and diarrhea
those with missing enzyme inability to metabolize lactose
treated milk lactaid
food intolerance
missing enzyme to break down food such as lactase for lactose
heart disease diet
low cholesterol diet less than 200 mg/day
consume low saturated fat diet
start exercising quit tobacco
1 glass of red wine a day reduces risk of CHD
CHF diets
reduce sodium intake 1,2,3mg
monitor fluid intake/ output
MI diet
liquid diet best for first 24 hours after
caffeine should be avoided since stimulates HR
counsel about heart healthy diet
Iron deficiency anemia
most common anemia
sources of iron
beef liver, red meat, fish, poultry, tofu, dried beans, whole grains, dried fruits/ peas
Vitamin B12 deficiency anemia
inadequate intake
natural sources fish, meat, poultry, eggs, milk
vegans need supplemental B12
Folic acid deficiency anemia
caused by malnutrition, malabsorption, drugs
sources are leafy green veggies, dried peas, beans, liver, seeds, OJ, fortified cereals/ breads, or supplements.
Diets for GI disorders
low fiber diet: slows gastric movement. used short term for diarrhea, acute diverticulitis, malabsorption syndrome, preparation for bowl surgery/ procedures
High fiber diets: foods containing > 5g/serving
helps increase stool bulk, stimulates peristalsis, prevents constipation, protects against colon cancer.
BRAT diet
B: bananas
R: Rice
A: applesauce
T: toast
causes of constipation
irregular bowl habits, PsychoGenic factors, inactivity, chronic laxative use/ abuse
obstruction
poor intake of fiber/ water
Causes of diarrhea
emotional/ physical stress, GI disorders, mal absorption conditions, infections, certain medications
diarrhea may cause loss of K, Na and fluid
Dumping syndrome
complications after gastric surgeries inhibits pyloric sphincter and control of food into the small intestines
no food one hour after eating or during meal
restrict lactose
recommend small frequent meals
nausea vomiting, dizziness rapid heartbeat hypo glycemia within 15 mins post eating
GERD
encourage weight loss avoid large meals at bedtime avoid trigger foods avoid fatty foods spicy foods caffeine alcohol cigarette smoke chocolate peppermint
Diverticulosis/ diverticulitis
inflammation of fecal matter getting trapped in diverticula
educate about high fiber diet
lower fiber intake
gluten restricted diet
wheat rye are omitted
celiac disease is a malabsorption disorder
ESRD
high protein low phosphorus low sodium low potassium
hypoglycemic
rules of 15 15g of carbs retest if 70-75mg/dl repeat steps 1tbsp honey 5 lifesavers 2-3 glucose tabs 15g extra if meal is an hour away and normalized
Albumin
synthesize in liver
low levels with malnutrition
burns wounds
chronic liver disease
prealbumin
20-42mg/dl
best marker of acute change
hemoglobin
composed of heme, an iron rich compound, a serum protein
iron needed to produce heme
low levels indicate bleeding or poor intake
decreased globulin level indicates protein intake deficiency or excessive protein loss
BMR basal metabolic rate
amount of energy required at rest
total energy needs are BMR + total activity
carbohydrates
4cal per g 45-65% advised in diet classifications: monosaccharides disaccharides polysaccharides stored in the liver and the muscles as glycogen for energy needs
Fiber
considered a carb no energy
for bowls
lowers colon cancer
Glucose
carbohydrate
abundant form of energy
stored as glycogen and broken down for energy
protein
plant or animal
nine amino acids linked
three types: complete
incomplete
complementary
functions: tissue building balance of nitrogen and water backup energy metabolic processes support of immune system
protein continued
needs increase during pregnancy, lactation, hemorrhage, burns, surgery or wounds.
10% of daily intake 46g for women and 56g per day for men.
4 cal /g energy
kwashiorkor
malnutrition caused by lack of protein while consuming adequate calories
poor appetite lethargic
growth retardation
Marasmus
malnutrition caused by lack of sufficient energy or calories
infants less than a year shrunken abdomen prominent ribs no fatty liver old man face requires high protein, fat and carbs.
cachexia
general physical wasting and malnutrition
comes with chronic disease
weight loss and deterioration in physical condition
protein excess
protein is broken down and nitrogen is excreted via kidneys
high protein and diet and monitor labs
lipids
9 kcal per g
secondary energy source
animal products (meat, milk, eggs) plants (seeds, nuts, and oils)
aids in fat soluble vitamins
types of fat
triglycerides: primary form of fat
phospholipid: cell membrane function from triglycerides
cholesterol
needed for cell membrane stability and hormone production
can build up leading to congestion
saturated fats
animal orgin
unsaturated fats
usually, plant source
essential fatty acids
omega 3/6
supports clotting
Enuresis
involuntary urination
Nocturnal Enuresis
nighttime bedwetting
Dysuria
painful or difficult urination
Nocturia
waking to urinate at night
Oliguria
urinary output <30ml/hr
Polyuria
output greater than 3000ml/day
Anuria
absence of urine
Hematuria
blood in urine
high fat diet leads to
obesity, CVD, hypertension, diabetes mellitus
low fat diet less than 10% leads to
leads to wasting
cholesterol facts
no plant foods contain cholesterol
vital part for hormone building
larger intake of intake leads to higher serum cholesterol
made by saturated fat and stored in the liver
desirable cholesterol levels
total: <200mg/dl
LDL: <130mg/dl
HDL: >45mg/dl
Vitamins
13 essential vitamins
water soluble- vitamin C and B complex
Fat soluble- Vitamin A, D, E, K
Water soluble
prone to destruction by heat or light.
not stored in large amounts in the body
B complex
B1: Thiamine B2: Riboflavin B3: Niacin or nicotinic acid B6: pyridoxine B9: Folic acid B12: cobalamin
Vitamin C
antioxidant, iron absorption
deficiency: scurvy, decreased iron absorption,
bleeding gums
B1 - Thiamine
helps change carbs into energy
whole grains eggs leafy greens
deficiency: can affect nervous, muscular, GI and CV systems
wet beriberi-
edema, weak heart muscles and vascular
Dry beriberi- paralysis, extreme muscle wasting.
dyspnea, foot drop, edema, orthopnea
Wernicke- Korsakoff syndrome
severe B1 deficiency
seen with alcoholism
sx: memory loss, extreme mental confusion, ataxia
TX: parenteral fluids should have B vits
can cause syndrome with increase of glucose to the brain in malnourished.
B2 - Riboflavin
source: milk, meat, leafy green
Used for: growth, energy. tissue healing.
B2- Riboflavin
deficiency
Cheilosis- skin eruptions
cracked lips, red swollen tongue
S/S: itchy burning eyes, lethargic, anemia, fatigue, oily skin, night blindness, developmental deformities
B3 - Niacin
aids in the metabolism of fats glucose and ETOH.
Source: Liver, Nuts legumes whole grains
B3 - Niacin
deficiency
pellagra (sun sensitive skin lesions) dementia
B6 - Pyroxidine
source: organ meat and grains
deficiency: anemia CNS
high intake may cause sensory neuropathy
S/S: seen in late stages, dermatitis, depression, confusion, glossitis
B9 - Folate (folic acid)
needed for prevention of utero defects spina bifida
anencephaly
amino acid synthesis
sources: liver, citrus fruit, whole grain products, leafy veggies
megaloblastic anemia
B-12 Cobalamin
needed for red blood production
pernicious anemia seen with strict vegans.
beef liver fortified grains.
Fat Soluble Vitamin
can lead to toxic levels
pts with liver disease need less
A, D, E, K
Vitamin A - retinol, beta carotene
Function: vision health, tissue growth
deficiency: night blindness, immune impairment.
Toxic: liver damage, appetite loss
Source: orange and yellow colored foods eggs/dairy
Vitamin D - Calciferol
helps absorption of calcium and phosphorus
regulates calcium blood levels bone/ teeth health.
Lack of it causes rickets in kids osteomalacia in adults
toxic causes hypercalcemia and hypercalciuria may cause kidney CV damage
Vitamin E - tocopherol
can cause nerve and muscle weakness and vision problems
low risk of toxicity. may prolong bleeding.
Vitamin K
for prothrombin production
single dose IM used for prophylactic at birth
warfarin antidote
Vitamin D found in
eggs and fortified milk sunshine
water
cant last more than 3 days without
young and old get dehydrated easy
signs of dehysration
headache, dry skin, dry mouth, concentration, tiredness, dizzy, thirsty (late sign)
fever in infants
minerals
16 essential minerals
major: calcium/ chloride/ magnesium, phosphorus, potassium, sodium, sulfur
Trace: 20mg
chromium, copper, cobalt, fluoride, iodine, manganese, molybdenum, selenium, zinc
electrolytes: sodium, potassium, chloride, calcium, magnesium
calcium
most abundant in body
nerve function
bone growth teeth formation, increase with age
calcium homeostasis happens by what 3 ways
bones release calcium
intestines absorb more calcium
kidneys retain more calcium
high calcium can cause
constipation
kidney stones
calcium rigor
sodium
low causes : muscle cramps dehydration cardiac changes
excess: fluid retention
hypertension
for maintain blood pressure
thirst
nerve impulses
potassium
For: nerve impulses
muscle contractions
promotes regular heartbeat
monitor ecg give supplements
toxicity: dysrhythmias
vomiting
deficient: cardiac dysrhythmias muscle cramps/ weakness/ confusion
banana broccoli, avocado
Magnesium
high: diarrhea, weakness, CV changes
low: weakness, arrythmias, tetany, seizures, reduced blood clotting, eclampsia
Trace minerals
iodine iron chromium cobalt cooper fluorine manganese molybdenum selenium zinc
BMI
under <18.5
healthy 18.5-24.9
overweight 25-29.9
obesity >30
Iodine
for thyroxine synthesis which is a thyroid hormone that helps regulate metabolism
low cause goiter
high is cretinism
RDA 100 -150mcg for adults
Iron
nonheme iron are from plant foods
heme iron is from animal
